Surgical instrument



PATENTED FEB. 9, 1904;

L. 0. HOLBROOK.

SURGICAL INSTRUMENT.

APPLICATION FILEIIOQT 12, 1903.

N0 MODEL.

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in patients unable to undergo the operation UNITED STATES Patented Februar 9, i964.

PATENT OFFICE.

LYMAN o. HOLBROOK, or CHARLOTTE, MICHIGAN.

SURGICAL INSTRUMENT.

SPECIFICATION forming part of Letters Patent No. 751,513,. dated. February 9, 1904:.

Application filed October 12, 1903.

To all whom it may concern.-

Be it known that I, LYMAN O. HOLBROOK, a citizen of the United States, residing at Charlotte, in the county of Eaton and State of Michigan, have invented a new and useful Surgical Instrument, of which thefollowing is a specification.

This invention relates generally to surgical instruments, and more particularly to instruments for elevating and sustaining in elevated position depressed portions of the cranium, thereby to relieve pressure upon the brain substance and to enable the natural processes of repair to cause complete union of the elevated portions of the cranium with the uninjured portions and prevent paralysis, epilepsy, and kindred ills frequently due to pressure upon the brain substance.

A special object of the present invention is to provide means whereby depressed portions of the cranium may be'elevated without cutting through the brain-wall by means of a trephine, thus avoiding in great measure the danger that invariablyaccompanies the trephining operation and making it possible to relieve pressure upon the brain substance of trephining on account of advanced age or any other condition rendering the employment of chloroform or ether too hazardous to justify the operation. 7

In describing the invention reference will be had to the accompanying drawings, in which there is illustrated one form of embodiment of the invention, the same being shown as applied to a section of the skull to raise a de pressed portion thereof.

In the drawings, Figure 1..is a plan view of the instrument- Fig. 2 is a view in vertical section through the instrument and through a portion of the skull to show the operation of the instrument in elevating portions of the skull which have long been depressed. Fig. 3 is a diagrammatic view showing the way in which the skull mustbe prepared for the operation of the instrument if the depression is one which has existed for a long time.

In the drawings, in which corresponding parts are designated by similar characters of reference, 1 designates a supporting member Serial No. 176,693. (No model.)

formed in the present instance of metal of suitable strength andweight and possessing thickness, arched in the middle to rise above the curvature of the skull and having the ends bent to conform as nearly as possible to the configuration of the skull adjacent to the seat of the injury. In the middle of the arch of the member 1 there is provided an opening 2,, through which a screw 3 passes! The screw 3 is unprovided with the usual head, but has the upper end reduced to present a squared portion 4, which forms a wrench'seat. Anut 5 is. in threaded engagement with the outer portion of the screw and serves to raise the screw through the opening 2 in the supporting member 1, which opening is of suflicient size to permit the free movement of the screw therein.

The skull or cranium is indicated at C in Figs. 2 and 3, and the depressed portion of the skull, which causes the pressure upon the brain substance, is indicated in dotted lines at 6. The position of the previously-depressed portion 'of the skull after the operation of the instrument is shown in solid lines at 7.

When the injury is an old one, union between the depressed fragments of the skull will have taken place, and in order to make the action of the instrument effective it will be desirable to cut around the center of the depression two or more concentric circles 8 and to bore into the skull at the center of these circles an opening 9. By means of awrench (not shown) engaging the squared portion 4 at the top of the screw the screw may be inserted to suflicient depth to obtain the required hold 'upon the bony structure of the skull.

Then the arched member 1 will be placed in tion of said depressed portions and simultaneousl y bringing together the edges of the outer circular kerf 8, while spreading apart the edges of the inner circular kerf. In case the depression of the skull is one of considerable depth it will be desirable to eifect the elevation by degrees, turning the nut a little from time to time, and so gradually restoring the bone to its original position without markedly altering the blood pressure within the cranial cavity or otherwise disturbing the norinal condition of the brain.

In applying the instrument local anesthesia, with cocaine, will be suificient to enable the patient to undergo the operation, and the danger from the use of ether or chloroform will thus be obviated. At the same time the great danger from infection, which always exists whenever the cranial cavity is opened, will be avoided.

In case the injury is one of recent occurrence the formation of the circular kerfs 8 in the cranium by means of a trephine may be dispensed with and the screw 3 inserted into the opening 9 without preparation of the skull other than the boring of the said opening.

After the parts have been raised to their normal position by the action of the instrument it will be desirable to keep the instrument in position for a length of time varying with the age and bodily condition of the patient in order to secure the union of the elevated portions of the skull with the surrounding uninjured portions, so as to prevent recurrence of the depression. During the time that the instrument remains in position there will naturally be more or less pain; but this will not ordinarily be very severe in character and may be easily overcome by the use of suitable analgesics, such as morphine, codein, and other compounds of more recent discovery.

Having thus described the nature and use of my invention, what I claim as new, and desire to secure by Letters Patent, is

1. An instrument of the class described, comprising an arched supporting member having ends bent to conform to the configuration of the skull and having a central aperture, a skull-engaging member mounted in said central aperture, and means for raising said skullengaging member.

2. An instrument of the class described, comprising a supporting member having a central aperture, a screw loose in said aperture, and a nut threaded on said screw above the supporting member.

3. An instrument of the class described, comprising a supporting member having a central aperture, a screw loose in said aperture and having its end shaped to present a wrench-seat, and a nut threaded on the upper portion of said screw.

4. An instrument of the class described, comprising an arched plate of resilient material having ends bent to conform to the configuration of the skull and having a central aperture, a screw loose in said aperture and provided with a squared upper end, and a nut threaded on the upper portion of said screw.

In testimony that I claim the foregoing as my own I have hereto aflixed my signature in the presence of two witnesses.

LYMAN O. HOLBROOK.

Witnesses:

GUY M. RowLnY, CARRIE T. STROTHER. 

